Using the Electronic Medical Record to Correlate Patient–Provider Perspectives in the Care of Black Individuals With High-Risk Pregnancies [ID 2683496

Abstract

INTRODUCTION: The electronic medical record (EMR) is a mainstay of medical documentation, although it is limited in its ability to fully capture patients' perspectives. This study aims to correlate patient and provider perspectives in the care of Black individuals with diabetes and/or hypertension in pregnancy to identify areas for quality improvement. METHODS: A mixed qualitative-retrospective study consisting of in-depth one-on-one interviews and EMR chart review was conducted from January 2021 to December 2022 for nine patients who self-identified as Black, were 6 weeks to 1 year postpartum with diagnoses of diabetes and/or hypertension during pregnancy or postpartum, and delivered at a tertiary hospital (IRB 2000028830). Interviews were virtual, lasted 55 minutes on average, and explored participants’ delivery and postpartum experiences. Chart notes were reviewed to correlate and compare participants' described experiences with documentation in the EMR. Themes were developed using inductive technique. RESULTS: Participants reported overall satisfaction with the care received, but four major themes were identified: 1) concerns with acknowledgement and management of pain, 2) perceived coercion and stereotyping with contraception counseling, 3) incomplete representation of positive and negative experiences in EMR documentation, and 4) balancing patient autonomy and professional responsibility to counsel. Although participants' described experiences were correlated to EMR documentation for some instances, documentation often lacked patient perspectives regarding their concerns and decision-making rationale. Additionally, participants did not always fully understand the rationale behind aspects of their care. CONCLUSION: Opportunities exist for improved patient–provider communication in the provision of obstetric care for minoritized populations with high-risk pregnancies.